Cannabinoids in Children: Safety Data from 23 Clinical Trials
What Researchers Found About Epilepsy and Cannabis
The Study at a Glance
Published
JAMA Pediatrics, 2024
Researchers
Multiple institutions (International)
Study Type
Meta-AnalysisParticipants
3,612 patients · Varies by trial
Key Finding
Cannabinoids used for medical purposes in children and adolescents were associated with an increased risk of adverse events, including 3x higher withdrawal rates due to adverse events and nearly 2x higher serious adverse events compared to controls.
Key Finding: Cannabinoids used for medical purposes in children and adolescents were associated with an increased risk of adverse events, including 3x higher withdrawal rates due to adverse events and nearly 2x higher serious adverse events compared to controls.
What Researchers Studied About Epilepsy and Cannabis
Cannabinoids are increasingly used for medical purposes in children, but evidence on their safety in this population is sparse. This creates a need for reliable safety information.
This systematic review and meta-analysis evaluated the adverse event profile of cannabinoids used medically in children and adolescents, analyzing data from randomized controlled trials.
The researchers searched MEDLINE, Embase, PsycINFO, and Cochrane Library through March 2024 for trials involving at least one participant 18 years or younger.
How This Meta-Analysis Was Conducted
From 39,175 citations screened, 23 randomized controlled trials with 3,612 participants were included.
Patient demographics: 17.6% female, 57.3% male. Eleven trials (47.8%) included only children/adolescents; 12 included mixed age groups.
The cannabinoid interventions studied were: - Purified cannabidiol: 47.8% of trials - Nabilone: 17.4% - THC: 13% - Cannabis herbal extract: 13% - Dexanabinol: 8.7%
The most common conditions treated were epilepsy (39.1%) and chemotherapy-induced nausea and vomiting (30.4%).
Epilepsy Treatment Results
The Main Results:
- 1Overall adverse events: 9% higher risk with cannabinoids (RR 1.09, 95% CI 1.02-1.16)
- 2Withdrawals due to adverse events: 3x higher risk with cannabinoids (RR 3.07, 95% CI 1.73-5.43)
- 3Serious adverse events: 81% higher risk with cannabinoids (RR 1.81, 95% CI 1.21-2.71)
- 4Diarrhea: 82% higher risk (RR 1.82, 95% CI 1.30-2.54)
- 5Elevated AST (liver enzyme): 5.7x higher risk (RR 5.69, 95% CI 1.74-18.64)
- 6Elevated ALT (liver enzyme): 5.7x higher risk (RR 5.67, 95% CI 2.23-14.39)
- 7Somnolence (sleepiness): 2.3x higher risk (RR 2.28, 95% CI 1.83-2.85)
By the Numbers
| Statistic | What It Means |
|---|---|
| 23 trials | Number of randomized controlled trials included (3,612 participants) |
| 3.07x | Higher risk of withdrawing due to adverse events with cannabinoids vs control |
| 1.81x | Higher risk of serious adverse events with cannabinoids vs control |
| 5.7x | Higher risk of elevated liver enzymes (AST and ALT) with cannabinoids |
Number of randomized controlled trials included (3,612 participants)
Higher risk of withdrawing due to adverse events with cannabinoids vs control
Higher risk of serious adverse events with cannabinoids vs control
Higher risk of elevated liver enzymes (AST and ALT) with cannabinoids
What This Means for Epilepsy Patients
If your child is using or considering cannabinoids for a medical condition, this research provides important safety information from 23 clinical trials.
Cannabinoids do carry increased risks in children and adolescents. The most concerning findings include significantly higher rates of serious adverse events, liver enzyme elevations, and treatment withdrawals due to side effects.
Common side effects observed include sleepiness (2.3x more common), diarrhea (1.8x more common), and elevated liver enzymes (5.7x more common).
This does not mean cannabinoids should never be used in children. For conditions like treatment-resistant epilepsy, the benefits may outweigh these risks. However, this research emphasizes the need for careful monitoring and discussion with healthcare providers about potential risks.
Quick Answers: Epilepsy and Cannabis
Direct answers based on the findings of this study:
Research Summary: Answers are based on published peer-reviewed studies and represent research findings, not medical recommendations. Individual results may vary. Always consult a healthcare provider before making treatment decisions.
Is medical marijuana safe for kids?
Cannabinoids carry increased risks in children. A 2024 JAMA meta-analysis of 23 trials (3,612 patients) found 3x higher withdrawals due to adverse events, 1.8x higher serious adverse events, and 5.7x higher liver enzyme elevations compared to controls.
Source: Chhabra et al., JAMA Pediatrics, 2024 (PMID: 39283619)
What are CBD side effects in children?
Somnolence (2.3x), diarrhea (1.8x), elevated liver enzymes (5.7x), and serious adverse events (1.8x). Children on cannabinoids had higher rates of these side effects compared to controls in clinical trials.
Source: Chhabra et al., JAMA Pediatrics, 2024 (PMID: 39283619)
Should children on CBD have liver tests?
Yes. The JAMA meta-analysis found children on cannabinoids had 5.7 times higher risk of elevated AST and ALT liver enzymes. Monitoring liver function is recommended for children using cannabinoid medications.
Source: Chhabra et al., JAMA Pediatrics, 2024 (PMID: 39283619)
This is educational content, not medical advice
The research summarized here is for informational purposes only. Individual results may vary, and what works in studies may not work the same way for everyone. Always consult with a qualified healthcare provider before making changes to your treatment plan or starting medical cannabis therapy.
Important Limitations
This study has some caveats to keep in mind when interpreting the results:
- Most trials focused on epilepsy and chemotherapy-induced nausea
- Long-term safety data beyond trial duration is lacking
- Drug-drug interactions need further study
- Heterogeneity in cannabinoid preparations and doses across trials
- Some trials included mixed age groups (children and adults)
The Bottom Line on Cannabis for Epilepsy
This JAMA Pediatrics meta-analysis of 23 trials (3,612 participants) found that cannabinoids in children and adolescents are associated with increased risks: 3x higher withdrawal rates due to adverse events, nearly 2x higher serious adverse events, and 5.7x higher liver enzyme elevations. While cannabinoids may still be appropriate for specific conditions like treatment-resistant epilepsy, parents and clinicians should be aware of these safety findings and ensure appropriate monitoring.
Do You Qualify for Medical Marijuana?
If you're living with Epilepsy, you may qualify for a medical marijuana card. Our licensed physicians can evaluate you from home via telehealth.
Related Research & Resources
Related Research
Condition Research
Get Your Card
This condition qualifies for medical marijuana in:
Source
Chhabra M, Ben-Eltriki M, Mansell H, et al. "Cannabinoids Used for Medical Purposes in Children and Adolescents: A Systematic Review and Meta-Analysis" JAMA Pediatrics. 2024. DOI: 10.1001/jamapediatrics.2024.3045
Important Information
Not Medical Advice: This research summary is for educational purposes only. It should not be used to diagnose, treat, cure, or prevent any disease or medical condition. Always consult a qualified healthcare provider before starting or changing any treatment.
Individual Variation: Research findings represent group averages. Your individual response to cannabis may differ based on genetics, other medications, underlying conditions, and many other factors.
Last reviewed: January 25, 2026
Important Notices
Research Summary Disclaimer
This content represents our interpretation of published scientific research for educational purposes. It should not be used to make treatment decisions without consulting a qualified healthcare provider. Individual results may vary from study findings.
FDA Notice
These statements have not been evaluated by the FDA. Cannabis is not intended to diagnose, treat, cure, or prevent any disease. The FDA has not approved cannabis for any medical condition except specific prescription medications.
Copyright & Fair Use
Research summaries are provided under fair use (17 U.S.C. § 107) for educational purposes. We provide brief summaries with attribution, not full reproductions. All studies remain the intellectual property of their respective authors and publishers.
Data Sources
Study information sourced from PubMed®, U.S. National Library of Medicine. Inclusion does not imply endorsement by NLM, NIH, or the federal government.
For complete information, see our Terms of Use and Research Content Policy.
FAQs: Cannabis for Epilepsy
Is CBD safe for children?
Yes, increased adverse events in children. This 2024 JAMA meta-analysis of 23 trials found cannabinoids were associated with 3x higher withdrawal rates, 1.8x higher serious adverse events, and 5.7x higher liver enzyme elevations vs controls.
What are the side effects of medical cannabis in children?
Common side effects from 23 trials include: somnolence (2.3x higher risk), diarrhea (1.8x higher risk), and elevated liver enzymes AST and ALT (5.7x higher risk). Serious adverse events were 81% more common.
What conditions are cannabinoids used for in children?
Epilepsy (39.1%) and chemo nausea (30.4%). In these trials, the most common conditions were epilepsy and chemotherapy-induced nausea and vomiting. The most studied cannabinoid was purified CBD (47.8% of trials).